The response to sleep-disordered breathing (SDB)-directed therapy was evaluated using the Clear Path home-based monitoring system. There were 26 patients with heart failure enrolled in the Sleep Events, Arrhythmias, and Respiratory Analysis in Chronic Heart Failure (SEARCH) study with SDB requiring treatment (apnea-hypopnea index [AHI] >or=15 events/h). Patients were monitored using both standard polysomnography and the Clear Path system to determine the change in SDB parameters before and after initiation of therapy. Accuracy of the Clear Path system compared with polysomnography was >or=87% to detect SDB events. A marked reduction in the mean number of sleep time respiratory disturbances was observed by both techniques after the initiation of SDB-directed therapy, and 21 patients (87.5%) experienced a 16.7-events/h mean reduction in AHI. Thus, the Clear Path system appears to be a useful device to monitor response to SDB-directed treatment for apnea in patients with heart failure.